The role of patient experience surveys in quality assurance and improvement: a focus group study in English general practice

Abstract

BackgroundDespite widespread adoption of patient feedback surveys in international health‐care systems, including the English NHS, evidence of a demonstrable impact of surveys on service improvement is sparse.ObjectiveTo explore the views of primary care practice staff regarding the utility of patient experience surveys.DesignQualitative focus groups.Setting and participantsStaff from 14 English general practices.ResultsWhilst participants engaged with feedback from patient experience surveys, they routinely questioned its validity and reliability. Participants identified surveys as having a number of useful functions: for patients, as a potentially therapeutic way of getting their voice heard; for practice staff, as a way of identifying areas of improvement; and for GPs, as a source of evidence for professional development and appraisal. Areas of potential change stimulated by survey feedback included redesigning front‐line services, managing patient expectations and managing the performance of GPs. Despite this, practice staff struggled to identify and action changes based on survey feedback alone.DiscussionWhilst surveys may be used to endorse existing high‐quality service delivery, their use in informing changes in service delivery is more challenging for practice staff. Drawing on the Utility Index framework, we identified concerns relating to reliability and validity, cost and feasibility acceptability and educational impact, which combine to limit the utility of patient survey feedback.ConclusionsFeedback from patient experience surveys has great potential. However, without a specific and renewed focus on how to translate feedback into action, this potential will remain incompletely realized.

Patient burden during appointment-making telephone calls to GP practices

“…The disadvantage of such methods is that they fail to explain how and when problems occur in encounters, and therefore we do not know what needs improving or how to improve. We also know that practice staff struggle to identify and action changes based on survey feedback alone [16]. This paper follows a growing body of research that demonstrates how evidence endogenous to interactions provides novel insights into how communication works, which can then inform training and interventions [17,18], which has been reported as near absent for GP receptionists [3].…”

Functionality and feedback: a realist synthesis of the collation, interpretation and utilisation of patient-reported outcome measures data to improve patient care

“…There's a kind of fixation on measurable outcomes but they don't really tell us what's going on. 236 Staff also drew attention to the trade-off between the increased relevance of local surveys that were less robust, versus the robustness of national surveys that were less specific to individual practitioners and did not include free-text comments. As one GP commented, 'We want to see data tailored to individual practitioner because we all practice [sic] differently'.…”

“…As one GP commented, 'We want to see data tailored to individual practitioner because we all practice [sic] differently'. 236 Patient complaints were seen as more useful DOI: 10.3310/hsdr05020 HEALTH SERVICES AND DELIVERY RESEARCH 2017 VOL. 5 NO.…”

“…As one administrator noted, 'I think we learn a lot more from patients that write to us individually about complaints'. 236 Participants also reported a number of changes they had made to services in response to the survey, including modifying their facilities, appointment systems and providing staff training. The changes largely related to organisational aspects of service delivery and operational matters.…”

“…The changes largely related to organisational aspects of service delivery and operational matters. However, the authors commented that, for most practices, changes were 'rarely attributable directly to the survey feedback'; 236 rather, the survey had provided a 'nudge' to implement changes they were already considering. Participants mentioned a number of difficulties in responding to issues highlighted by the patient survey, including not having the resources to acquiesce to perceived unrealistic patient expectations (e.g.…”